Psychological therapies for sickle cell disease and pain

Sickle cell disease is a group of blood disorders. It can cause anaemia, which if severe can reduce mobility. It may also allow small blood vessels to become blocked causing pain in muscle and bone and it can damage major organs such as the spleen, liver, kidneys, and lungs. People with sickle cell disease are more vulnerable to severe infections. Treatment is usually in response to symptoms and designed to ease pain. Psychological treatment to help people cope with sickle cell disease might complement current medical treatment. There are four types of treatment: patient education; cognitive therapy (to do with thoughts and feelings); behavioural therapy (to do with actions); psychodynamic psychotherapy (talking to relieve emotional pain). We searched for randomised or quasi-randomised controlled trials which compared psychological treatments to each other or to no treatment in sickle cell disease. We included six studies in the review. Four studies with 223 people had data we could enter in the review. One study showed that cognitive behaviour therapy reduced the affective part of pain, but not the sensory part. Another study of this therapy had inconclusive results for coping strategies and showed no difference on how different groups used the health service. One education study did not show a reduction in depression. The authors believe that some patient education seems relevant for children and adolescents, while methods to improve the ability to cope in both children and adults are important. However, more research needs to be done in this area.